R175 Naka, R., Amano, H., & Ito, T. (2014). A case study of healing touch on Parkinson’s disease in community nursing: Focusing on reducing pain, emotional distress, and insomnia Journal of International Society of Life Information Science, 32(1), 34-37.

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Journal oflnlernationa/ Society ofLife Information Science (/SUS) [~]
J Inti. Soc. Life Info. Sci. Vol.32, No.1, March 2014
The 37th Symposium on life Information Science
March 15-16, 2014, Toho University Omori Medical Center, Tokyo, Japan
34
A Case Study of Healing Touch on Parkinson's Disease
in Community Nursing
- Focusing on Reducing Pain, Emotional Distress, and Insomnia -
Rumi NAKA Hiroshi AMANO and Takehiko IT0
2
1
NPO International Healing Associationfor Nurses (Chiba, Japan)
2
Wako University (Tokyo, Japan)
Abstract: [Purpose] The purpose of this study was to clarify effects of healing touch on a patient with
Parkinson's Disease (PD). [Method] A 74-year-old female patient with PD was assessed before and after a
one-hour weekly healing touch treatment for five months to determine changes in specific symptoms.
[ResuIts] The effects of healing touch were found in terms of palliation of muscle contracture, progress of
psychological relaxation, and improvement of insomnia. [Discussion] The effects of healing touch for
patients with PD can be identified in three ways, i.e., decrease of physical pain, reduction of
psychological burden, and easing a difficult lifestyle.
Keywords: Healing touch, community nursing, Parkinson's disease, palliative care
1. Introduction
Healing touch (HT), a biofield therapy, is one of the
effective nursing techniques as described in
"Evidence-Based Nursing Care Guidelines" (Ackley,
Ladwig, Swan, & Tucker, 2008). HT uses light touch to
influence the human energy field, centers and meridians
to induce inner harmony and enhance self- healing
(Wardell, 2008) Recipients report increased relaxation,
reduction of pain and increased quality of life (Wardell,
2008). The American Holistic Nurses Association
endorses the standardized education of HT in the
approved programs (American Holistic Nurses
Association). Complementary therapies such as HT are
proving to be effective in many situations based on a rich
amount of research (Wardell, 2008). Both of the healing
touch professional organizations (Healing Touch
International and Healing Touch Program) provide
international certification. HT has been integrated into
the pain management programs of many hospitals,
supported by medical staff and may be covered by some
medical insurance companies (Osterlund, 1999).
However, in Japan the practice of healing touch is
relative new and research of HT in Japan is scarce.
Henneghan and Schnyer (2013) reviewed the extant
palliative care literature for outcomes using the biofield
therapies of healing touch, therapeutic touch and reiki.
They found no studies specific to end of life care but did
find numerous studies on relevant populations such as
patients with cancer and chronic pain. Outcomes in
Takehiko ITO. take@wako.ac.jp
Wako University, Kanai 2160, Machida, Tokyo 195-8585, JAPAN.
those populations indicated improved quality of life
including stress reduction and reduction of pain. Naka,
Amano, & Ito (2013) reported on a pretest-posttest
design research conducted in Japan where HT was given
to 14 patients with different major complaints in the
context of home visit nursing Outcomes were positive
indicating that HT was effective as a t)rpe palliative care.
Therefore it seems that HT might be applicable for
patients with Parkinson's Disease (PD), which is one of
the incurable diseases, needing palliate care for pain and
to improve quality of life.
2. Purpose
The purpose of the present study was to clarify the
effects of healing touch on a patient with Parkinson's
Disease (PD), focusing on physical pain control,
reduction of psychological pain, and improvement of
msomma.
3. Method
The design was a case study of weekly HT provided
during one-hour home visits, including an energy
assessment before and after the HT intervention. The
results of energy assessment of the first and last sessions
were compared. Data were collected from June to
October (5 months) 2013 by a trained healing touch
practitioner apprentice (practitioner) in the final stages of
a year-long supervised practicum. The participant was a
74-years-old female with PD who lived at home.

2. 35JournalofInternationalSociety oflife Information Scie~~ce (ISliS) ~]
J Inti. Soc. Life Info. Sci. Vo/.32, No.1, March 2014
The 37th Symposium on life Information Science
March 15-16, 2014, Toho University Omori Medical Center, Tokyo, Japan
4. Ethical considerations
Before the intervention, the practitioner explained the
research to the patient to help her understood the purpose
and use of data, her freedom to participation and
withdraw from the study if she chose to, and because she
was interested in participating the practitioner had her
sign a written informed consent. During the interventions,
the practitioner practiced based on the established
procedures and ethical standards of Healing Touch
International (20 13).
5. Results
Intake : June 2013
This was a 74-year-old woman with PO, who lived
with her 82-year old husband. The husband was also
certified as being in need of care and received visiting
care and nursing. The daughter lived in their
neighborhood and visited once in a while to see how
they were. According to the daughter, the woman had
been a dependable mother who loved painting and
singing She was a leader, and worked as a PTA
committee member.
Her medical history included an onset of Parkinson's
disease in 1980 indicating a young onset and a
stereoencephalotomy in 1997. The client had 'on-off
phenomenon' and trunk dystonia with noticeable tremors
and drooling. She had right and left femoral neck
fracture surgeries. Having severe delusions and illusions
due to the side effect of the anti-Parkinson medication
she complained about her husband's past infidelity and
sometimes became emotionally unstable.
Her Hoehen and Yahr rating was stage 5
(confinement to bed or wheelchair unless aided) and the
Functional Severity was stage 3 (dysphagia and tends to
eat less), therefore, she was given racol when she was
not well enough to take chopped foods. Her response
was inconsistent, thus communication could become
difficult. Although she spoke relatively more in the
morning, she had less stamina in the afternoon and
hardly spoke. Because she could respond to the
practitioner's questions, she attempted to communicate
by asking yes-no questions and using a communication
board.
Using this method the practitioner found the client
had severe tension in her cervical neck region and
complained of pain. She could not open her right hand
because of the severe contractures. As she spent most of
her time in a wheelchair during the day; her whole body
leaned to the right side. Therefore, she was assisted to a
position by supporting her with a cushion. She felt cold
in her hands and feet. Although she used diapers, she
could sometimes use the toilet when she wished to do so.
Her oral medications were commonly used to treat the
symptoms of PO and constipation: menesit, comtan
(entacapone), trerief (zonisamide), prusennid, alosenn,
laxoberon, and glycerin enemas. Following the direction
of the doctor, the practitioner visited her home once a
week and introducing HT as part of the practitioner's
visiting nurse's palliative care.
The first month's evaluation (June)
Nursing process for HT:
The basic process of healing touch includes nine
steps: intake, practitioner preparation, assessment,
problem statement, mutual goals, interventions, post
treatment assessment, releasing from patient's energy
field, and 'grounding' patient and evaluation. Selected
aspects of the process are presented next.
Practitioner's preparation
The practitioner deepened and slowed her breathing,
while standing behind the client, becoming fully present
and connecting to the earth's energy. Next, the
practitioner focused on her energetic hara-line, filled
herself with the earth energy and set her intention to be
neutral (non-judgmental and not to be attached to the
outcome). Finally, the practitioner put her hands on the
client's shoulders intending to connect their heart chakra
and for the energy of love and light to flow for the
highest good of the client, thus, the practitioner was
prepared.
Energy assessment
First the practitioner, by using her hands, felt the
nature of the all the chakras (spinning vortexes of
energy) from the lower root to crown at the client's head
and noted they were oval shaped instead of round, which
was diminishing the intake and output of energy. A
tingling vibration was especially strong around her heart
and throat chakras. Next, assessing for balance, the
practitioner moved her hands over the client's energetic
field (aura) and felt a strong tingly sensation emanating
from her entire aura. It was especially strong around her
head area, which suggested the presence of 'congested'
energy.
Problem presentation
There was a lack of smooth flowing energy, which
might have been caused by the pain of muscle
contractures due to the PD.
Mutual goals
Long-term goals were to: reduce the client's delusions
and illusions and gain emotional stability.
Our short-term goals were to: alleviate the muscle
contracture, throbbing pain, and insomnia.
The intervention and rationale for healing touch
strategy.
First, the practitioner did magnetic clearing in order to
achieve the short-term goal; creating and balancing an
energetic flow throughout the body so that the muscle
contractures due to the PO could be alleviated and the
client's fixed position for long period of time and the

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Journal oflntemaUona/Society oflife Information Science (/SUS) 00,]J. lntl. Soc. Life Info. Sci. Vo/.32, No.1, March 2014
The 37th Symposium on life Information Science
March 15-16, 2014, Toho University Omori Medical Center, Tokyo, Japan
36
stress could be eased. As the practitiOner repeatedly
moved her hands slowly and steadily above the client's
body, through her energy field for the magnetic clearing;
a kind of lingering or drifting energy stayed around the
practitioner's hands for a while, which after about 15
minutes became lighter, smoother and less lingering
indicating that the auric energy blocks had diminished.
Second, the practitioner did what is termed 'mind
clearing', which is actually to energetically balance the
energy flow between the brain hemispheres in order to
achieve the long-term goal. During the mind clearing,
the practitioner felt a strong tingly vibration particularly
around the top of the client's head and her brow chakra,
which was transmitted as far the practitioner's soles,
therefore she continued until the tingly sensation
subsided indicating balance was achieved.
Energy assessment after a treatment
Although some of the tingly sensation still remained
in the entire aura, all the chakras from the root through
crown became almost round shaped and had a more
vigorous spin; thus they became better able to circulate
the energy in her body.
Grounding and release
After the treatment the client was so relaxed the
practitioner needed to touch her feet and speak to her, to
wake her up from her deeply relaxed state. The
practitioner promoted her grounding (being fully awake
and consciously in her body) by giving her some foods.
The practitioner disengaged herself from the client's
energy field.
Evaluation and feedback
Because during the treatment, the client could have
intense spasms when supine, the practitioner advised the
helper and the family to make sure that she takes the oral
medication next time. The practitioner told them to
continue it as long as it is not too difficult for her.
Although she had some fatigue, she then had a stable
course. The client appeared to be feeling the flow of
energy and the expression on her face was softened a
little.
Follow-up
Because of the client's physical impairment and the
difficulty in communication, the practitioner suggested
making the affirmations of the Hawaiian Ho'oponopono
(Thank you, I'm sorry, I love you and please forgive me)
as part of self-care since it was something she could do.
The last evaluation (51
h month)
With regard to the long-term goal - reducing the
delusions and illusions and gaining emotional stability - ,
there was much improvement as the expression on her
face had softened and she made fewer disquieting
comments.
However, the doctor noticed that the symptoms had
not yet completely disappeared, so he, as well as her
family, requested continuation ofHT.
With regard to the short-term goal - alleviating the
muscle contracture and throbbing pain and having a
sound sleep at night - , she hardly complained of the
throbbing pain and she started to have a relatively sound
sleep at night.
Although the muscle weakness and the difficulty in
swallowing were still observed, she no longer needed to
take the medication, racol, and was able to ingest
chopped foods.
Her entire body still leaned to the right side as before.
The contracture in the right hand, the tensions in the ·
neck and back muscles had eased greatly and had
become softer, thus she ceased complaining. She could
stretch her body when lying on the bed and her fingers
had a wider range of motion. Her palms and joints also
became soft enough to play thumb wrestling.
After five months of HP therapy her emotions of
anxiety and anger diminished and she had a more calm
expression on her face. By clearing and balancing her
energy field, she became livelier and spoke more.
She no longer complained of poor sleep and said she
can sleep well now. The tendency to be constipated
decreased. Her hands and fingers became warmer and
she had a calmer expression on her face. She said that
she felt better after receiving the HT. Both the client and
her family, hoped to continue the healing touch
treatments. The doctor also recommended continuing
with HT as a nursing care.
Fig.1. 1stmonth Fig. 2. 5th month
As shown in Figs. I & 2, her posture in sitting had
changed dramatically in five month.
6. Discussion
The effects of healing touch were found in terms of
palliation of muscle contracture, progress of
psychological relaxation, and improvement of insomnia.
We identified three potential effects of healing touch for

4. 37JournaloflnternaUona/ Society ofLife Information ScientJ~J (/SllS) ~]
J Inti. Soc. Life Info. Sci. Vo/.32, No.], March 2014
The 37th Symposium on life Information Science
March 15-16, 2014, Toho University Omori Medical Center, Tokyo, Japan
patients with PO: decreasing physical pain, reducing
psychological burden, and easing lifestyle habits.
Naka, Amano, & Ito (2013) found positive effects of
HT with 14 patients in care at home. They compared
physical, affection, thinking, and spiritual factors with
pre- and post-tests. They found statistically significant
improvements and no untoward side effects. In the
present case study, we also found physical, mental and
life style beneficial changes. The results suggest the
effectiveness of HT for people with PD.
Healing Touch Program (2013) points out at least
four benefits of HT: (1) non-invasive, (2) effective, (3)
non-toxic, and (4) economical. The use of HT in home
nursing visit would be mostly beneficial from this point
of view. As Naka, Amano, & Ito (2013) discovered, HT
is one of the positive ways of intervening with
participants' satisfaction. It is not only an effective and
efficient therapy; it is very safe for patients. It costs less
in terms of devices, preparation time, and location. HT
intervention is one of the most promising approaches in
home healthcare for the patients, family members and
visiting nurses. It is an approach to improve quality of
nursing in general.
This study is limited by the single case approach that
was descriptive in nature. The findings did generate the
possibility of HT as an important adjunct to PO and
palliative care.
In addition, other research (Henneghan & Schnyer)
reports effectiveness of HT for chronic conditions. The
number of patients living in home is increasing in this
society. Community nursing must pay more attention to
those approaches to help patients feeling better, such as
palliative care, pain control, and relaxation through
healing touch and other complementary therapies.
In order to protect patients' safety, further intervention
and evaluation of healing touch by nurses who have
mastered community -nursing skills are necessary. It is
also important to compare effectiveness of HT with other
complementary and alternative therapies.
Acknowledgments
We are thankful to Prof. Dr. Sarah E. Porter RN
(Certified Healing Touch Practitioner and Instructor) for
valuable comments on our draft.
References
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30,2014 from:
http//www.ahan.org/Education/Program-Endorsement
2) Healing Touch International: International code of
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http://www.healingtouchinternational.org
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